Job Description
Description:
Our Company: Revco Solutions provides best-in-class Revenue Cycle management to Hospital and Physician Service clients.
Position Description : The Insurance Recovery Specialist serves as the primary point of contact for patients with questions about their health insurance coverage, claims, and balances. This role handles both inbound and outbound calls, providing accurate, clear, and courteous communication regarding insurance claims that may be pending with insurance or assigned as patient responsibility. The representative will also process payments and work with patients to resolve outstanding balances.
Major Areas of Responsibilities :
· Inbound/Outbound Call Handling – Respond promptly to incoming calls and initiate outbound calls to patients regarding insurance claims, coverage questions, and balance inquiries.
· Insurance Claim Assistance – Review and explain claim status, including pending insurance determinations, coordination of benefits, and denials.
· Patient Balance Resolution – Clearly communicate patient responsibility amounts, explain billing statements, and collect payments via phone in compliance with company policies.
· Problem Resolution – Research and resolve patient concerns by accessing claim details, insurance plan information, and payment history.
· Payment Processing – Accurately record and process payments, payment arrangements, or financial assistance referrals.
· Documentation – Maintain thorough and accurate account notes detailing all patient interactions and actions taken.
· Compliance – Adhere to HIPAA guidelines, company policies, and applicable state/federal regulations.
· Collaboration – Coordinate with internal teams (billing, insurance follow-up, and collections) to ensure timely resolution of accounts.
Qualifications :
· High school diploma or equivalent; some college preferred.
· Minimum 1–2 years of customer service experience in healthcare, insurance, or a call center environment.
· Exceptional customer service skills, including empathy, patience, professionalism, and the ability to maintain composure in challenging situations.
· Knowledge of health insurance terminology, benefits, and claims processing.
· Strong communication and active listening skills, with the ability to explain complex information in a patient-friendly manner.
· Proficiency in data entry and computer navigation within multiple systems.
· Ability to handle high call volumes while maintaining professionalism and empathy.
· Strong organizational skills and attention to detail.
Work Environment :
· Office-based or remote (as applicable).
· Hours are 7:30am-6:00pm CST/8:30am-7:00pm EST.
Requirements: